OBJECTIVE: To evaluate several conventional cervical smears obtained from women undergoing routine screening for cervical dysplasia or carcinoma and whose smears contained structures resembling collagen balls. STUDY DESIGN: Between 1995 and 1998, cervical smears containing collagen balls were analyzed. The clinical histories of the patients whose smears contained collagen balls, ...

OBJECTIVE: To investigate the feasibility of transperineal ultrasonography for uterine cervical assessment by determining the correlation of uterine cervical length measurement from transabdominal, transperineal and transvaginal ultrasonography and comparing discomfort arising from each technique. MATERIAL AND METHOD: Fifty pregnant women of 37 weeks' gestation or later who gave consent participated ...

OBJECTIVE: To estimate whether cervical and lower uterine segment characteristics other than cervical length and funneling predict recurrent preterm birth. METHODS: We conducted a secondary analysis of a multicenter, blinded observational study of 181 women with singletons and prior spontaneous preterm births. Endovaginal ultrasonic examinations were performed at 2-week intervals ...

OBJECTIVE: The Foley catheter is a safe and effective form of preinduction cervical ripening and is quickly growing in popularity. Its major effect appears to be through mechanical dilation, which has raised the concern that the use of the Foley catheter for cervical ripening may damage the cervix and result ...

PROBLEM: We investigated whether cervical shortening and high interleukin (IL)-8 in cervical mucus were valuable indications for treatment to prevent premature birth and preterm, pre-labor rupture of membranes (pPROM). METHOD OF STUDY: Pregnant women were divided into group A, in which neither cervical IL-8 nor cervical length was measured in ...

OBJECTIVE: To compare pregnancy outcome for women at risk of preterm delivery undergoing elective cervical cerclage in the first trimester or serial transvaginal assessment of cervical length with cerclage only if indicated (control cases). DESIGN: A matched case control study. SETTING: Prematurity clinic at two London teaching hospitals. POPULATION: Women ...

Objective: To determine the Pregnancy Complications and Outcome following Cervical Cerclage Operations. Subject: The case records of 76 patients who underwent Cervical Cerclage Operation for Cervical incompetent at the University of Maiduguri Teaching Hospital between January, 1983 and December 1999 inclusive were reviewed. In all the patients the diagnosis of ...

BACKGROUND: First-trimester abortion in women with cervical stenosis results in difficult or impossible suction curettage. We present the case of an early pregnancy in a woman with cervical stenosis after cone biopsy in which the pregnancy was terminated by transvaginal needle aspiration of the gestational sac under echographic guidance. CASE: ...

AIM: Aim of the study was to investigate the efficacy of single transvaginal ultrasound-guided intraamniotic installation of methotrexate in the management of cervical pregnancy with concurrent review of the literature. MATERIALS AND METHODS: Six patients with cervical pregnancy are included in the study. All patients were treated with single transvaginal ...

A rare case of a term-pregnancy and delivery in a patient with microprolactinoma is presented. The patient had been treated with bromocriptine since she was 17 due to primary amenorrhea for 60 months with short intervals. Pharmacological tests with dopamine antagonists and X-ray diagnostics revealed the presence of microprolactinoma. The ...

OBJECTIVE: Report of a rare case of consecutive spontaneous cervical pregnancies. DESIGN: Case study. SETTING: Teaching hospital. PATIENT(S): One healthy nulliparous woman in the early years of her fourth decade. INTERVENTION(S): The first of two cervical pregnancies was treated with two doses of methotrexate and subsequent uterine artery embolization. The ...

The purpose of this study was to compare the fertile phase of the menstrual cycle as determined by the Clearplan Easy Fertility Monitor (CPEFM) with self-monitoring of cervical mucus. One-hundred women (mean age = 29.4 years) observed their cervical mucus and monitored their urine for estrogen and luteinizing hormone metabolites ...

OBJECTIVE: To determine whether sonographic measurement of cervical length in twin pregnancies presenting with threatened preterm labor helps distinguish between true and false labor. METHODS: In 87 women with twin pregnancies presenting with regular and painful uterine contractions at 24-36 (median, 30) weeks of gestation, cervical length was measured by ...

OBJECTIVE: To examine the potential value of routine measurement of cervical length in singleton low-risk pregnancies at 37 weeks of gestation in the prediction of onset and outcome of labor. METHODS: Cervical length was measured by transvaginal sonography at 37 weeks in 1571 singleton low-risk pregnancies. Outcome measures were gestation ...

Gynaecological malignancies frequently occur in women of reproductive age and are estimated to complicate approximately one in 1000 pregnancies. The incidence of gynaecological malignancies during pregnancy is expected to rise as more women delay childbearing into their later reproductive years, and maternal age is the most powerful predictor of cancer ...

BACKGROUND: Transabdominal cervicoisthmic cerclage is a procedure carried out to increase the fetal salvage rates in women who are poor candidates for the more usual procedure of transvaginal cerclage or for those with previously failed vaginal procedures. Although several modifications have been applied to the original procedure in an attempt ...

The gradual disorganization of collagen fibers in the stromal connective tissue of the uterine cervix is characteristic of progressive cervical softening during pregnancy. A lack of thrombospondin (TSP) 2 has been shown to be associated with altered collagen fibril morphology of connective-tissue-rich organs such as skin and tendon. The goal ...

OBJECTIVE: To assess the role of repeating a Pap smear at the time of colposcopy performed within 6 months of a referent Pap smear. MATERIALS AND METHODS: A clinical database was queried to identify colposcopies performed within 6 months of a referent abnormal squamous Pap smear at which time a ...

OBJECTIVE: The purpose of this study was to compare preterm delivery rates and neonatal morbidity/mortality rates for women with cervical incompetence with membranes at or beyond a dilated external cervical os that was treated with emergency cerclage, bed rest plus indomethacin, versus just bed rest. STUDY DESIGN: Women with cervical ...

Although cervical epidural steroid injection with local anaesthetic is considered a safe technique and widely practiced, complications may occur. We report a patient experiencing unexpected delayed high block, moderate hypotension and unconsciousness eight to ten minutes after an apparently normal cervical epidural steroid injection. The most probable diagnosis was a ...

BACKGROUND: Cervical pregnancy is a rare condition that can become life-threatening if heavy bleeding occurs. CASE: Grace (pseudonym) is a 32-year-old woman who was admitted to hospital at approximately 6 weeks' gestational age after several days of heavy bleeding. Ultrasonographic examination revealed the presence of cervical pregnancy. She received multiple ...

As the uterus enlarges to accommodate the growing fetus during pregnancy, the cervix behaves essentially as a barrier. During ripening and delivery, it needs to become soft and distensible to allow dilation and the passage of the conceptus. As the transformations of the collagen-containing fibres are known to be essential ...

OBJECTIVE: To assess the role of transvaginal sonographic cervical length in predicting spontaneous preterm delivery at < 32 weeks in patients with both triplet pregnancy and therapeutic cerclage. STUDY DESIGN: The maternal records of all triplet pregnancies with therapeutic cerclage and sonographic cervical length before and after cerclage were reviewed ...

OBJECTIVE: To describe a rare case of conservative treatment of an 11-week cervical pregnancy after a period of heavy bleeding. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 33-year-old woman was admitted to our hospital for treatment of a cervical pregnancy. Two-and-a-half years thereafter, she gave birth to a ...

Cervical incompetence causes repeated mid-trimester miscarriage and preterm delivery with high fetal wastage. Since the introduction of cervical cerclage in 1951, it has undergone many changes with regard to the techniques, indications and postoperative care. The objective of this study is to review the changing trends in the current indications ...

OBJECTIVE: The purpose of this study was to evaluate the efficacy and outcomes of patients undergoing conization utilizing a technique of loop-cone cerclage when a diagnostic cone biopsy was required in pregnancy. METHODS: All loop conizations between 1997 and 2001 were reviewed; 15 patients were identified who underwent cone- cerclage ...

OBJECTIVE: To estimate the effectiveness of prophylactic and therapeutic cerclage by meta-analysis of randomized clinical trials. DATA SOURCES: We searched the Cochrane Pregnancy and Childbirth Group specialized register of clinical trials (May 2002). Congress proceedings of international society meetings of fetal-maternal and reproductive medicine were searched by hand. METHODS OF ...

BACKGROUND: Cervico-isthmic pregnancy is a rare occurrence and until the use of current ultrasonographic techniques was associated with a disastrous outcome for women desiring to maintain their fertility. CASE REPORT: A 39-year-old woman was diagnosed at 12 weeks of amenorrhoea with an intra-uterine non-viable pregnancy and a low implantation of ...

OBJECTIVE: To compare the efficacy of a nitric oxide donor (isosorbide mononitrate) and a prostaglandin E1 analogue (misoprostol) for cervical priming before suction termination of pregnancy. METHODS: This was a randomized, double blind, placebo-controlled trial. One hundred twenty-six healthy women requesting termination of pregnancy between 9 and 12 weeks' gestation ...

This study sought to determine whether 3-D transvaginal ultrasound (3D-TVS), compared with the 2-D transvaginal approach (2D-TVS), offers a better identification of some specific features of the uterine cervix that could be useful in the prediction of spontaneous preterm delivery (PTD). A total of 103 women with singleton pregnancies were ...

OBJECTIVE: To compare the efficacy of oral versus vaginal metronidazole treatment in pregnant women with bacterial vaginosis, and to compare cytokine profiles (interleukin-1beta, -6, and -8) in the cervical secretions of these women before and after treatment. METHODS: Pregnant women with bacterial vaginosis diagnosed both by Gram stain and clinical ...

Before parturition the uterine cervix undergoes a ripening process ("softens" and dilates) to allow passage of the fetus at term. The exact mechanism(s) responsible for cervical ripening are unknown, though a role for peptidergic sensory neurons is emerging. Previous work demonstrated that administration of substance P (SP) to ovariectomized rats ...

STUDY OBJECTIVE: To evaluate and describe our experience in the management of recurrent second-trimester miscarriage and preterm delivery by laparoscopic transabdominal cervicoisthmic cerclage (LTCC), after failure of transvaginal cervical cerclage. DESIGN: Retrospective review (Canadian Task Force classification III). SETTING: Tertiary care teaching hospital. PATIENTS: Twenty women in whom it was ...

The purpose of this report is to describe outcomes following laparoscopic transabdominal cervico-isthmic cerclage placement in cases of cervical incompetence not amenable to a conventional transvaginal procedure. We reviewed records of the first 11 patients at an academic teaching hospital who underwent laparoscopic transabdominal cerclage placement as an interval procedure, ...

OBJECTIVE: To evaluate the success rate of transabdominal cervicoisthmic cerclage (TACIC) as an elective and emergency procedure for cervical incompetence in comparison to reported success rates for vaginal cerclage. STUDY DESIGN: Retrospective review was performed of the hospital records of patients and their neonates who underwent TACIC for cervical incompetence ...

OBJECTIVES: To construct charts for cervical length in a low risk population measured by transvaginal ultrasonography. METHODS: Pregnant women of an apparently normal population were seen in the ultrasound division of the University Women's Hospital Basel between 20 and 34 weeks of gestation and underwent once (one measurement per subject) ...

OBJECTIVE: To describe a cervical neuroblastoma revealed in the prenatal period. METHOD: We were recently confronted with a case of fetal solid neck mass suggestive of teratoma, which proved postnatally to be a neuroblastoma. Combining this case with a review of recent literature, we have evaluated the diagnostic tools required ...

OBJECTIVE: To investigate the use of omental graft following the repair of fistula between bladder and uterus (Youssef syndrome). METHODS: Primary repair was performed on four women who had developed vesico-uterine/vesico-cervical fistula and infertility due to previous low segment caeserean between October 1997 and January 2001. An omental graft of ...

OBJECTIVE: To examine the effect of parity on the relationship between pre-induction cervical length and the induction-to-delivery interval and rate of vaginal delivery within 24 h in women undergoing induction of labor for prolonged pregnancy. METHODS: In 382 singleton pregnancies, induction of labor was carried out at 41 + 3 ...

We present an unusual case of a primigravida with a viable cervical pregnancy diagnosed by transvaginal ultrasound and magnetic resonance imaging. Staggered conservative therapeutic measures included systemic high-dose Methotrexate with Folinic acid rescue followed by bilateral embolization of the uterine arteries in response to active cervical bleeding despite declining serum ...

OBJECTIVE: To determine what constitutes normal cervical changes in twin gestations during the latter half of pregnancy, and whether there are differences in the pattern of cervical change between women expecting twins giving birth at term (> or = 36 completed gestational weeks, GW) and preterm. METHODS: Twenty women (12 ...

OBJECTIVE: To evaluate cervical length in the nongravid period in women with a past history of preterm delivery. METHODS: The study population comprised 54 women who had delivered spontaneously before 34 weeks of gestation. Etiology of preterm delivery was suspected to be related to cervical incompetence, defined as a painless ...

To provide some insight into the mechanism of cervical ripening, the expression of type I collagen was investigated in human uterine cervical tissues obtained from the first (n = 4) and third (n = 3) trimesters of normal pregnancy. Indirect immunofluorescent staining was performed for type I collagen, and Northern ...

OBJECTIVES: Evaluation of prophylactic intrapartum amnioinfusion in women with oligohydramnios. METHODS: Assiut University Hospital during the period from February 2000 to September 2001, 160 laboring women with oligohydramnios [amniotic fluid index (AFI) </=5 cm] were randomized into: amnioinfusion and control groups. Inclusion criteria were: term singleton gestation, vertex presentation, cervical ...

Prior to parturition the non-pliable uterine cervix undergoes a ripening process ("softens" and dilates) to allow a timely passage of the fetus at term. The exact mechanism(s) triggering and involved in cervical ripening are unknown, though evidence for a role for sensory neurons and their contained neuropeptides is emerging. Moreover, ...

OBJECTIVE: To compare the efficacy of 400 microg of misoprostol with that of 1 mg of gemeprost as cervical priming agents when administered vaginally 3 to 4 hours before first-trimester vacuum aspiration abortion. METHODS: In a prospective controlled trial 90 nulliparous women who requested termination of pregnancy before 12 weeks' ...

The study was a review of the clinical features used to diagnose cervical incompetence. One hundred and forty-one clinical records of patients who had cervical cerclage inserted for cervical incompetence at the University of Maiduguri Teaching Hospital over a 5-year period, were studied retrospectively. Previous mid-trimester abortion occurred in 80.1% ...

OBJECTIVE: The objective of this study was to investigate the predictive factors of premature rupture of the membranes (preterm PROM). METHODS: The study was undertaken with cervical secretions collected from 72 consenting singleton pregnant women between 20 and 33 weeks of gestation. The levels of interleukin (IL) 1alpha, IL-1beta, IL-6, ...

OBJECTIVE: To assess the factors associated with delivery greater than or equal to 28 weeks' gestation after placement of an emergent cerclage in women with singleton gestations. METHODS: All women who underwent emergent cerclage, defined as any cerclage placed between 16 and 24 6/7 weeks' gestation in response to documented ...

BACKGROUND AND OBJECTIVES: Cervical epidural block is useful in the management of a variety of acute, chronic, and cancer-related pain syndromes involving the head, face, neck, and upper extremities. Knowledge of the depth from the skin to the cervical epidural space (DSES) may be helpful when performing cervical epidural block ...